EGUS – equine gastric ulcer syndrome (as seen in July 2015 issue of The Rider)

Let’s save the boring stats that every article discussing equine gastric ulcers quotes. If you keep your horse in a stall and/or do any level of training and you are still reading this article, there is an extremely high probability your horse has ulcers.

Why? Murray (1994) demonstrated that alternating periods of feeding and withholding hay resulted in progressive erosion and ulceration of the gastric squamous epithelial mucosa (upper portion of the stomach). Further to this, concentrate (grain feeding) has been implicated in the development and progression of ulcers (Nadeau et al., 2000). Confinement in stalls is implicated as well, but confounded by the above-mentioned factors of grain feeding and anything less than constant feeding/grazing of forages (Murray and Eichorn, 1996).

There is a good chance if your horse in in training, it is going through some level of feed deprivation, grain feeding and/or being housed in a stall and is likely to develop or has already developed ulcers. Not to oversimplify this complicated issue, but the literature constantly points to two root causes of ulcers: 1) stress and 2) feed deprivation. You cannot overlook stress; as the smallest change in environment and routine will cause a horse stress.

Determining if your horse definitively has ulcers is no easy task. Clinical signs of ulcers are non-specific and include lack of appetite, weight loss/poor body condition, mild or recurrent colic and loose feces (Bell et al., 2007). There are no hematological or biochemical markers currently available to diagnose ulcers (Vatistas et al 1999). Shall we repeat this point together? There are no markers available from a blood or fecal sample to diagnose gastric ulcers! Endoscopic evaluation is the only way to be certain, but even then, degree of ulceration does not always correlate to symptoms.

Management and diet is the first place to start for treatment of ulcers, but sometimes other interventions are necessary based on the horse’s profession/activities. Proton pump inhibitors, like Omeprazole, are one of the most common treatments. Less common are the H2 receptor antagonists, such as Cimetidine. They both attempt to do the same thing, limit acid production in the stomach and increase pH of the stomach. This is great for treating ulcers, but not so great for digestion, as that is the main purpose of the stomach, to acidify food and activate local enzymes. These drugs have been used quite successfully to help alleviate symptoms and treat ulcers, but as with all classes of drugs, continued use is not without concern and cost to most horse owners.

This leaves owners searching for alternatives. The market is overrun with supplements claiming to aid the treatment of ulcers, but few if any have more than anecdotal evidence of efficacy. This leaves most horse owners at cross roads, stick with chronic drug treatment or try to navigate through the sea of claims in the supplement marketplace and hope the dollars spent will provide their competitive companion with more than a placebo for the owner.

Alternatively, horse owners can look to a clinically tested alternative to drugs that utilizes the latest in nutraceutical ingredients to both alleviate the pain of ulcers and promote healing. Visceral+ was developed and tested in conjunction with veterinarians to help reduce the reliance on Omeprazole treatments and has successfully concluded clinical trials, with very positive results.

An oft asked question, but one difficult to answer is: “how long will it take before the ulcers heal?” Murray et al (1994) found that superficial lesions may take as little as 7 days to heal, but with deeper wounds, it may take up to 3 months to heal. That is a wide range. Not only was degree of ulceration important, but location impacted healing time. Furr and Murray (1999) indicated that lesions along the margo plicatus took the longest time to heal. Furthermore, the cause must be removed for complete healing to occur. Without removing the root cause, one can expect to deal with complications from ulcers or to at least have to maintain their horse on treatments for ulcers until such time as the root causal agent can be removed.

Gastric ulcers are a frustrating reality of competitive horses that costs not only in performance, but welfare as well. Providing an optimal diet and environment is obviously the best solution, but when this can’t always be the case, at least suitable treatments are available to maintain the health, welfare and performance of your equine companion.

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Mad Barn’s founder, Scott Cieslar has 10+ years as a professional nutritionist, having earned a Master’s of Science in Physiology and Nutrition, and he is currently completing his PhD at The University of Guelph in Canada. Suffice it to say, he knows his stuff.